• IMMUNE NETWORK
• /
• v.7 no.2
• /
• pp.87-94
• /
• 2007

Background: Chronic rhino-sinusitis and persistent allergic rhinitis is often cited as risk factor for developing adenoid hypertrophy or adenoiditis, but this relationship has not been studied extensively. In this study, we evaluated the mucosal barrier, squamous changes of ciliated epithelium, IgA secretion and BCL-6 expression in adenoids, and adenoid size. Methods: Six children with allergic rhinitis and sinusitis, nine children with only allergic rhinitis, nine children with only sinusitis and six children without any history of allergic rhinitis and sinusitis were enrolled. H-E stain of adenoid for squamous metaplasia, immunohistochemical study of adenoid for IgA and BCL-6, cytokeratin stain for evaluation of mucosal barrier and lateral view X-ray for adenoid size were performed. ANOVA test was used in the analysis and data showing p value of less than 0.05 were considered significant. Results: The number of ciliated cells had tendency to be decreased and squamous metaplasia had tendency to be increased in three experimental groups (p>0.05). Deterioration of mucosal barrier had tendency to be detected in three experimental groups than control group (p>0.05). BCL-6 had tendency to be increased and IgA secretion had tendency to be decreased in three experimental groups (p>0.05). There is no difference in adenoid size between three experimental groups and control group. Conclusion: Despite the expectation that adenoid would be affectecd by allergic rhinitis and rhino-sinusitis, we found no evidence for influence of adenoid immunity.

• Clinical and Experimental Pediatrics
• /
• v.50 no.3
• /
• pp.315-318
• /
• 2007

This report describes the long-term follow-up of a 10-year-old female patient with Joubert syndrome with short stature and brachydactyly. She presented with hyperpnea alternated with hypopnea, uncontrolled jerking eye movements, and hypotonia during early infancy. She was diagnosed with Joubert syndrome based on clinical symptoms and typical MRI findings at 5 months of age. Abnormal ventilation and eye movements disappeared at around 4 years of age. Head circumference kept within normal range for her age, but her height and weight growth were markedly retarded. Simple X-ray showed an enlarged skull with increased digital markings, hypoplasia of facial bones, and abnormal enchondral bone formations in hands and feet. This article is the first report of Joubert syndrome with peripheral dysostosis.

• Imaging Science in Dentistry
• /
• v.45 no.4
• /
• pp.205-211
• /
• 2015

Purpose: This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Materials and Methods: Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. Results: The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Conclusion: Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

• Imaging Science in Dentistry
• /
• v.51 no.4
• /
• pp.383-388
• /
• 2021

Purpose: The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars. Materials and Methods: Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level. Results: The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant(P>0.05) and the kappa value for inter-observer agreement was found to be 0.957. Conclusion: Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.

• Journal of the Korean Society of Radiology
• /
• v.83 no.3
• /
• pp.744-749
• /
• 2022

Fibrosing mediastinitis is a rare benign disorder characterized by the proliferation of dense fibrous tissue within the mediastinum. It typically manifests as localized or infiltrative soft-tissue masses in the middle mediastinum or hilar area, which cause compression and encasement of adjacent mediastinal structures, such as the vessels or airway. Here, we report a rare case of fibrosing mediastinitis in a 13-year-old girl that presented as a middle mediastinal mass lesion on CT scan with obliterating left lower lobar bronchus. The patient's symptoms and follow-up chest CT showed significant improvement following systemic corticosteroid treatment. As fibrosing mediastinitis can improve with systemic steroid therapy, radiologists must be aware of its radiologic findings when discriminating between infiltrating soft tissue lesions in the mediastinum.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.17 no.2
• /
• pp.63-68
• /
• 2017

Gaucher disease (GD) is caused by the deficiency of glucocerebrosidase. In pediatric patients with GD, especially Type I GD, enzyme replacement therapy (ERT) can reduce the hepatosplenomegaly and improve the hematologic finding and growth velocity. Herein, we report a 2-year-old girl with Type I GD presented with hepatosplenomegaly, bone pain and growth retardation. A 2 year-old-girl was referred to our hospital due to severe hepatosplenomegaly and growth retardation. She suffered from both leg pain and chronic fatigue. Simple x-ray showed widened distal long bones like that of an 'Erlenmeyer flask' which is associated with GD. The laboratory test showed anemia and thrombocytopenia. The enzyme activity was markedly reduced and the direct sequencing of the GBA gene showed the compound heterozygous mutations, p.G46E and p.L444P. As the G46E have been considered as the protective gene against neuronopathic genotype, we could assess the Type I GD in this patient. After one year of ERT, the growth velocity became 11 cm per year. Bone pain and fatigue disappeared. The volume of liver and spleen was reduced from $683cm^3$ and $703cm^3$ to $590cm^3$ and $235cm^3$, respectively. Although GD is an extremely rare disease in Korea, growth retardation and bone pain in children are the important signs which lead to early detection of GD and a simple radiologic finding is helpful to assess the GD at outpatient clinic. We highlight that the early diagnosis and early ERT is important for good growth and outcome for pediatric patients with GD.

• Pediatric Infection and Vaccine
• /
• v.23 no.2
• /
• pp.94-101
• /
• 2016

Purpose: This study aimed to describe the results of a contact investigation on health care workers after exposure to a house officer with smear-positive pulmonary tuberculosis (TB). Methods: Eighty nine out of 101 subjects who had close contact with the index patient agreed to be enrolled in the investigation. The first contact investigation was conducted approximately 30 days after the index patient's onset of symptoms, followed by the second investigation after 10 weeks. In both, clinical manifestations were studied, and chest X-ray and tuberculin skin test (TST)/QuantiFERON-TB Gold (QFT-G) in dual screening strategy were conducted. Results: The first TST resulted in positive in 34 subjects (38.2%). QFT-G was conducted on 16 subjects who tested positive in the first TST and aged under 36. Six of them (37.5%) were positive. The second TST was conducted on 41 subjects with negative results in the first TST. Seventeen (41.5%) were positive and among them, three (17.6%) showed positive QFT-G. None of the subjects were diagnosed with active TB. The probability of TB infection through contact with the index patient was 7.3% (3/41) in dual screening strategy while it was 41.5% (17/41) in TST strategy. Conclusions: This first hospital-setting contact investigation for tuberculosis in Korea revealed that latent tuberculosis infection (LTBI) rates vary depending on different diagnostic strategies. This indicates the need for systematic guidelines for diagnosing LTBI in health care workers who have professional exposure to TB.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.2
• /
• pp.194-198
• /
• 2009

Purpose: Severe abdominal distension is not uncommon symptom in the neonate. Two major causes of this symptom are benign transient intestinal ileus (BTII) and Hirschsprung`s disease (HD). But it is difficult to differentiate BTII from HD based on the symptoms and simple abdominal x-ray findings. The aim of this retrospective study was to assess the clinical aspects and diagnostic tests differencing two diseases. Methods: From August 2004 to March 2009, nineteen patients with severe abdominal distension, who underwent barium enema, anorectal manometry, and rectal suction biopsy (triple tests) due to a suspicion of HD, were enrolled. A comparison of clinical data associated with BTII and HD based on the clinical features and results of triple tests. Results: The age of onset of symptom was between 2 and 6 weeks in BTII and within 3 weeks in HD. On the barium enema, transitional zone revealed in 6 (50%) patients in BTII and 4 (57.1%) in HD. On anorectal manometry, the anorectal inhibitory reflex was present in 11 (91.7%) patients in BTII and 1 (14.3%) in HD. On rectal suction biopsy, ganglion cell was present in 9 (75%) patients in BTII and 0 (0%) in HD. Abdominal distension was improved within 3 months of life in all cases of BTII. Conclusion: We think that anorectal manometry may be more simple and useful diagnostic method than barium enema and rectal suction biopsy for differential diagnosis of transient intestinal ileus and Hirschsprung's disease.

• Pediatric Infection and Vaccine
• /
• v.9 no.2
• /
• pp.201-207
• /
• 2002

Purpose : We analyzed clinical features and causal viruses of acute lower respiratory tract infections(LRTIs) in order to improve the management of these infections. Methods : From end of April to early May 2001, amongst 30 children at a local institute for children's adoption and welfare, 13 were admitted to the hospital with the diagnostic impression of acute LRTIs. Nasopharyngeal aspirates were sent in Seoul National University Hospital for viral culture of respiratory syncytial virus(RSV), adenovirus, parainfluenza virus. Results : One or more viral agents were identified in 4 cases(30.7%) : were RSV(15.4%), adenovirus(7.7%), and a mix of these two viruses(7.7%). Initial symptoms were fever(69%), cough(100%), tachypnea(54%), chest retraction(69%), rale(85%) and wheezing(15%). Leukocytosis was noted in 23%, CRP increased more than 10 mg/L in 46%. Chest X-ray abnormalities were 69%. Conclusion : Although viruses were identified in 30.7%, further studies should be made for prevention and treatment of acute viral LRTIs.

• Pediatric Infection and Vaccine
• /
• v.13 no.2
• /
• pp.180-185
• /
• 2006

Invasive Pseudomonas infections most often occur in the immunocompromised patients and are associated with high mortality rate. Rarely this disease may develop in healthy infants and children. We report two cases of invasive Pseudomonas aeruginosa infections that were diagnosed in otherwise healthy infants. The first case was a previously healthy 5-month-old infant with ecthyma gangrenosum and septicemia. She presented with fever, swelling of left periorbital area and multiple erythronodular skin lesions. Each skin lesion formed a black eschar surrounded by an erythematous areola over time. Cultures of blood, urine and discharge from skin lesions grew P. aeruginosa. On the day of visit, she showed pancytopenia which was normalized after 10 days. The patient responded well to the management with ceftazidime and tobramycin. The other case was a previously healthy 9-month-old infant with community-acquired pneumonia. He was referred from an outside hospital with fever and cough. Chest x-ray revealed pneumonic infiltrations on both lower lungs with pleural effusion on the right side. Cultures of blood and pleural fluid grew P. aeruginosa. Chest CT performed on the ninth day demonstrated pneumatoceles, lung abscess and necrosis of lung parenchyma. He was managed with ceftazidime and amikacin for 50 days. No residual pulmonary complications were noted during the three month follow-up. Laboratory results to evaluate immunologic defects of phagocytic cells, complement components and T- and B-lymphocytes were all within normal range in both patients. It should be kept in mind that Pseudomonas can be, though uncommon, a cause of community-acquired invasive infections in the previously healthy infants.